This SCOR is directed to basic and applied problems in IRDS. In program areas relating to pulmonary surfactant, respiratory secretions, perinatal asphyxia, hemodynamics and gas exchange we propose to develop improved understanding of basic mechanisms of IRDS, means for its prevention and early diagnosis, and methods for its better treatment. Our Neonatal Intensive Care Unit (NICU) is also the continuing focus for participatory education in perinatal medicine for physician/nurse teams in our region of Central Pennsylvania. Specific research projects concern: regulation of, differentiation by, and protein turnover in the isolated Type II cell; biochemical characterization of mucus glycoproteins; role of the central nervous system in perinatal respiratory control; cerebral metabolic responses to asphyxia; cardiovascular determinants of vascular hypotension; development of non-invasive monitors of pulmonary function. The approach is multidisciplinary throughout and the scope extends from the molecular to the community levels.